Material and Method: Computerized delivery records, collected between January 2002 and December 2012 at Rajavithi Hospital, were retrospectively reviewed. We compared the condition of women of maternal age ≥45 years with singleton delivery and beyond 24 weeks of gestation (n = 82) in a 1:4 ratio with those women age 20 to 29 years (n = 328).

Results: Extremely advanced maternal age was significantly associated with a higher incidence of gestational diabetes mellitus (OR = 5.33; CI = 1.90-14.95), preeclampsia (OR = 4; CI = 1.99-8.06), preterm birth (OR = 1.74; 95% CI = 1.15-2.62), cesarean delivery (OR = 4.18; 95% CI = 2.52-6.93), postpartum hemorrhage (OR = 6.5; CI = 2.79-15.16), blood transfusion (3.7% vs. 0%; p = 0.008), placenta previa (OR = 16; 95% CI = 1.18-141.25), low birth weight (OR = 2.77; 95% CI = 1.23-6.25), very low birth weight (OR = 3.00; 95% CI = 1.07-8.4), low Apgar scores at 5 minutes (OR = 2.77; 95% CI 1.23-6.25), and perinatal death (OR = 6.00; 95% CI = 1.73-20.77).

Conclusion: Women aged 45 or more experienced increased maternal and neonatal adverse outcomes when compared with younger women. Women in an extreme age group are advised that although they might face a significantly increased risk of complications, most of them could have successful outcomes. An extremely advanced age is not contradicted for pregnancy. Obstetricians must be especially careful when taking care of extremely advanced age pregnancy.

Keywords: Advanced maternal age, Pregnancy, Complication, Neonatal, Outcome